Kevin Hague on Health

Returning to my roots of many years ago, I offer you this podcast. Green MP Kevin Hague, the former CEO of the West Coast District Health Board, discusses the National Party’s direction on healthcare, or rather their lack thereof, since coming to power last year. Kevin has a unique insight because he has been on the inside for so long…

In keeping with the Green Party’s kaupapa, the podcast is here in open format:

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6 thoughts on “Kevin Hague on Health”

“1. The overall health status of a population group is very strongly associated with the relative marginalisation or disempowerment of that group; and

2. The continued failure to honour the Treaty of Waitangi is unquestionably a major source of marginalisation and disempowerment for Maori.

Naturally, sitting behind both of these statements there is a considerable weight of evidence.” [says you]

Statement 1 stands but Statement 2 is drawing a very long bow with a lot of “ifs” and “buts” for example:

1. What do we have to do to honour the treaty of Waitangi? The treaty guarantees Tino rangitiratanga so there are territorial and resource issues to consider and power sharing (a departure from one man one vote). Have the Greens figured out the details regarding satisfying the treaty or will they just talk and shake a stick?
2. Who is a marginalised Maori? If you were to gather all Maori ancestors from 5 generations back you would find a majority of Pakeha.
3. What marginalizing situation do you refer to 1840 to 1890?
4. Do you assume that Pakeha are more suited to modern industrial society than Maori?

I support masked_marsoe and his/her assertion that VLC is great on all platforms. I would add that WinAmp and many of it’s sub-variants will play ogg files, on all platforms. Even M$ will give you a code plugin for vorbis formats.

I just wish that Apple would embrace the open format. I had my iPod given to me as a gift, and it will not play all my ogg files come hell or high water! I am now having to laboriously convert much of my library into that other proprietary format, mp3

1. The overall health status of a population group is very strongly associated with the relative marginalisation or disempowerment of that group; and

2. The continued failure to honour the Treaty of Waitangi is unquestionably a major source of marginalisation and disempowerment for Maori.

Naturally, sitting behind both of these statements there is a considerable weight of evidence.

Perhaps the most important point, however, is glossed over in this logic: we are used to thinking of health as an attribute of individuals, but these individually-based approaches fail to explain the overall pattern of health and disease in any society. We instead need to think in terms of communities and population groups, and those factors impacting on that scale. Not all individual Maori have poor health, but Maori as a whole have substantially poorer health than non-Maori as a whole.

In the particular speech jh referred to I drew a distinction between interventions intended to work at an individual level and those that impact on communities. The fact is that mostly interventions at the individual level, which tend to focus on giving an individual more information so that they can make a “healthy choice” are ineffective. That is because the construct of choice in many of our behaviours (eating, drinking, taking drugs, having sex, smoking etc etc) is a gross oversimplification. Choice implies a rational evaluation of and selection between alternative courses of action, but in fact those with the poorest health status have the least ability to make such a choice, because of their social and other circumstances. Health education thus tends to work best for those who least need to change behaviour.

In relation to the theme of the podcast, it is programmes operating at this end of the spectrum – those intended to improve or maintain wellbeing and those intended to treat early – that will be at risk as Mr. Ryall looks for areas to cut expenditure in order to fund his new elective surgery operating theatres (and Herceptin for that matter). The consequence, unfortunately will be an acceleration of chronic (long term) conditions like heart disease, diabetes, depression and consequent demand for more specialised (and expensive) health services in the future.

Green Party policy is to shift investment into public health programmes (those designed to keep people well) and primary care – the reverse of what Ryall seems intent on doing.

It is a nice practice to include a link to the appropriate downloadable tools when making content available in a non-standard format. I have no idea where to find a *.ogg player. Can you point me to one please?